Thoracic Cancer
Conditions
Brief summary
The investigators want to investigate if a diaphragmatic traction-suture affects the pleural cavity volume, as well as improves visual overview of a surgical field during minimally invasive thoracic surgery.
Detailed description
A visually good surgical field is essential in performing safe and optimal dissection of anatomical structures during Video Assisted Thoracoscopic Surgery (VATS). A number of patients referred to VATS-surgery appear with an elevated diaphragm, reducing visibility and complicating safe surgical techniques, thus entailing conversion from VATS into an open Thoracotomy. Some surgeons handle the decreased visibility due to an elevated diaphragm by increasing the amount of ports during VATS. Others have benefited from attaching a traction suture on the diaphragmatic posterior tendinous part, thus flatting the diaphragmatic dome when the suture is tightly retracted through the camera-port. It turns out that most thoracic surgery clinics are not familiar with this technique. There are also no articles regarding this topic in medical literature. We want to investigate if the diaphragmatic traction-suture affects the pleural cavity volume, as well as improves visual overview of a surgical field during minimally invasive thoracic surgery.
Interventions
PROCEDUREDiaphragmatic traction-suture
Measurement of pleural cavity volume before pulling the diaphragmatic traction-suture Measurement of pleural cavity volume after pulling the diaphragmatic traction-suture
Sponsors
Odense University Hospital
Study design
Allocation
NON_RANDOMIZED
Intervention model
CROSSOVER
Primary purpose
BASIC_SCIENCE
Masking
SINGLE (Subject)
Masking description
Volume of saline in pleural cavity and surgical field overview before and after pulling traction suture
Intervention model description
During video-assisted thoracoscopic surgery a diaphragmatic traction-suture is placed posteriorly at the border between the central tendinous part and the peripheral muscular part. Body temperate saline solution is then poured into the pleural cavity until the cavity is filled up to the soft-tissue retractor in the utility port. The volume of saline in the pleural cavity is then measured and registered before and after distal contraction of the diaphragmatic traction suture through the camera port. Subsequently the surgeon will be asked to evaluate and rate the surgical field visual overview, before and after contraction of the suture. Furthermore, anonymized video recordings focusing on the pleural cavity visual overview before and after distal contraction of the suture, will be presented to specialist thoracic surgeons for a blinded evaluation.
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* known or suspected lung cancer * scheduled for VATS-surgery * perioperative finding of elevated diaphragma
Exclusion criteria
* not willing to give informed consent. * perioperative finding of pleural adherences * perioperative finding without an elevated diaphragma
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Pleural cavity volume before | 1 minute after applying the traction suture | Pleural cavity volume (ml) before distal retraction of the diaphragmatic traction suture. |
| Pleural cavity volume after | 2 minute after applying the traction suture | Pleural cavity volume (ml) after distal retraction of the diaphragmatic traction suture. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Visual overview | 1 minute after applying the traction suture | The surgeon's evaluation of the surgical field visual overview before and after distal retraction of the diaphragmatic traction suture using a numeric rating scale (1-10). |
Countries
Denmark
Outcome results
None listed